Oral or nasal delivery of a medicament using an inhalation device is a particularly attractive method of drug administration as these devices are relatively easy for a patient to use discreetly and in public. As well as delivering medicament to treat local diseases of the airway and other respiratory problems, they have more recently also been used to deliver drugs to the bloodstream via the lungs thereby avoiding the need for hypodermic injections.
In one type of conventional metered dose inhalation device, the powdered medicament is held in a reservoir within a dispensing device that is operable to measure out and dispense a predetermined amount of powder for each dose. However, these devices suffer from poor dose metering capability especially when the size of the dose is relatively small as it is difficult to accurately measure out small amounts of dry powder in such a device. It is also difficult to protect the drug from the ingress of moisture and to seal it from the atmosphere until it is required for administration to a patient.
It is common for dry powder formulations to be pre-packaged in individual doses, usually in the form of capsules or blisters which each contain a single dose of the powder which has been accurately and consistently measured. A blister is generally cold formed from a ductile foil laminate or a plastics material and includes a puncturable lid which is permanently heat-sealed around the periphery of the blister during manufacture and after introduction of the dose into the blister. A foil blister is preferred over capsules as each dose is protected from the ingress of water and penetration of gases such as oxygen in addition to being shielded from light and UV radiation all of which can have a detrimental effect on the delivery characteristics of the inhaler if a dose becomes exposed to them. Therefore, a blister offers excellent environmental protection to each individual drug dose.
Inhalation devices that receive a blister pack comprising a number of blisters each of which contain a pre-metered and individually packaged dose of the drug to be delivered are known. Actuation of the device causes a mechanism to open a blister so that when the patient inhales, air is drawn through the blister entraining the dose therein that is then carried out of the blister through the device and via the patient's airway down into the lungs.
It is advantageous for the inhaler to be capable of holding a number of doses to enable it to be used repeatedly over a period of time without the requirement to open and/or insert a blister into the device each time it is used. Therefore, many conventional devices include means for storing a number of blisters each containing an individual dose of medicament. When a dose is to be inhaled, an indexing mechanism moves a previously emptied blister away from the opening mechanism so that a fresh one is moved into a position ready to be opened for inhalation of its contents.
A problem with conventional inhalation devices is that they are relatively large, heavy and difficult to operate. Despite their large size, many of them only have sufficient capacity to hold a relatively small number of doses before the device must be opened and a fresh set of blisters mounted therein. Although it may be possible to increase the number of blisters by making them smaller, this can only be achieved at the expense of reducing the dose payload or capacity of each blister. This is particularly disadvantageous when the device is to be used to deliver for example newer, less potent drugs where each blister must be able to hold a payload of somewhere in the region of 10-20 mg of the drug.
Due to their nature and method of operation, conventional inhalation devices have a relatively complicated construction and consist of many separate components making them difficult and time consuming to assemble as well as being expensive to manufacture and purchase.
A conventional inhalation device of the type described above is known from U.S. Pat. No. 4,811,731. This device is configured to receive a disc-shaped dose storage blister pack in which the doses are arranged in a generally circular pattern. A plunger is provided which moves in response to the actuation of a lever to puncture a blister disposed beneath it to enable the dose to be inhaled from the punctured blister. The device also includes a separate indexing device operable to rotate the disc so as to move a fresh blister to a puncturable position. A significant problem with this device is that the number of doses is severely limited. As can be seen from the device shown in the Figures, it is capable of receiving only eight doses at a time so frequent replacement of the disc is necessary. Although it will be appreciated that the disc can be made larger to accommodate a larger number of blisters, this would result in a significant increase in the overall size of the device making it very bulky. It is also notable that the piercing and indexing steps are controlled entirely independently of each other making the device significantly harder to use and increasing the number of components forming the device.
Another known inhalation device is described in U.S. Pat. No. 6,032,666. Although this device receives a strip of blisters, it has a very complicated construction with numerous components making it hard to assemble and operate. It is limited by the fact that access to the dose contained in each blister is obtained by peeling the lid off it rather than by piercing it. Therefore, the device has a complicated mechanism for peeling the lid from the blister including a take-up spool for the peeled lid strip and a complex clutch arrangement to ensure that the same length of lid is peeled from the strip each time the device is used as more and more of the lid strip is wound around the take-up spool. These components, together with the requirement to store the peeled lid within the device, increases its complexity and overall size as well as making it harder to re-fill with a fresh strip of blisters. It will also be appreciated that this device can only be used with a strip of blisters in which the lid is peelably attached to the blister. Not only does this require a suitable adhesive, it also reduces the barrier to moisture and other environmental contaminants.